Self-compassion and post-stroke depression symptoms in acute stroke survivors.

BACKGROUND: Post-stroke depression affects approximately one-third of stroke survivors. Self-compassion has emerged as a protective factor against depression in chronically ill populations, yet has received limited investigation in stroke survivors. OBJECTIVES: This study examined the factorial structure and reliability of the German Self-Compassion Scale Short Form (SCS-D-KF) in stroke survivors and investigated whether self-compassion is associated with depressive symptoms beyond established risk factors. METHODS: This cross-sectional study examined 407 patients (60.4% male) with acute stroke. Participants completed the SCS-D-KF and PHQ-9 within the first week post-stroke. Factor structure was tested using exploratory and confirmatory factor analysis. Associations with depressive symptoms were examined using hierarchical latent structural equation modeling (SEM) with full information maximum likelihood estimation. RESULTS: Factor analysis revealed a two-factor structure: Compassionate Self-Responding (CS; ωcat = 0.63) and Uncompassionate Self-Responding (UCS; ωcat = 0.82). In separate hierarchical latent SEM models controlling for sociodemographic and clinical risk factors (R2 = 0.312), UCS demonstrated the strongest incremental validity (ΔR2 = 0.057, β = -0.316, p < .001), followed by total self-compassion score (ΔR2 = 0.036, β = -0.290, p < .001) and CS (ΔR2 = 0.013, β = -0.201, p = .048). CONCLUSION: Both uncompassionate and compassionate self-responding demonstrated incremental validity beyond established risk factors, with uncompassionate self-responding showing particular salience in the acute phase. Results warrant consideration of self-compassion in post-stroke depression assessment and may serve as a potential intervention target pending longitudinal validation.